What is the role of lab tests in the workup of metastatic and advanced prostate cancer?

Updated: Dec 29, 2020
  • Author: Martha K Terris, MD, FACS; Chief Editor: Edward David Kim, MD, FACS  more...
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In cases of suspected advanced prostate cancer, the hematologic workup should include a complete blood count (CBC), liver function tests (LFTs), and a chemistry profile, including levels of serum creatinine, acid and alkaline phosphatase, and serum prostate-specific antigen (PSA), as well as a free-to-total PSA ratio. Any demonstration of abnormalities by these tests may warrant additional studies.

Note that not all patients with a relatively high-grade prostate cancer have elevated PSA levels, nor do elevated PSA levels always signify disease progression.

Urinalysis should be performed. If the results are abnormal (ie, indicating the presence of an infection), urinalysis should be followed by a urine culture, especially if the patient is symptomatic.

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